Nonoperative management of adolescent idiopathic scoliosis (AIS) using braces

Theodoros B Grivas; Stefano Negrini; Carl-Eric Aubin; Angelo Gabriele Aulisa; Jean Claude De Mauroy; Sabrina Donzelli; M Timothy Hresko; Tomasz Kotwicki; Edmond Lou; Toru Maruyama; Eric C Parent; Manuel Rigo; John G Thometz; Man Sang Wong; Fabio Zaina

doi:10.1097/PXR.0000000000000117

Nonoperative management of adolescent idiopathic scoliosis (AIS) using braces

Prosthet Orthot Int. 2022 Aug 1;46(4):383-391. doi: 10.1097/PXR.0000000000000117. Epub 2022 Mar 23.

Authors

Theodoros B Grivas¹, Stefano Negrini², Carl-Eric Aubin³, Angelo Gabriele Aulisa⁴, Jean Claude De Mauroy⁵, Sabrina Donzelli⁶, M Timothy Hresko⁷, Tomasz Kotwicki⁸, Edmond Lou⁹, Toru Maruyama¹⁰, Eric C Parent¹¹, Manuel Rigo¹², John G Thometz^{13

14}, Man Sang Wong¹⁵, Fabio Zaina¹⁶

Affiliations

¹ Department of Orthopaedics and Traumatology, "Tzaneio" General Hospital of Piraeus, Piraeus, Greece.
² Director Physical and Rehabilitation Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
³ Department Mechanical Engineering, Polytechnique Montreal & Sainte-Justine University Hospital Center, Montreal, Canada.
⁴ Orthopaedic Department, Children's Hospital, Bambino Gest, Institute of Scientific Research, Rome, Italy.
⁵ Department of Orthopedic Medicine-Clinique du Parc, Lyon, France.
⁶ Physical and Rehabilitation Medicine, ISICO-Italian Scientific Spine Institute, Milan, Italy.
⁷ Associate Professor of Orthopaedic Surgery, Harvard, Medical School, Boston Children's Hospital, Boston, MA, USA.
⁸ Prof. and Head of Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland.
⁹ Department of Electrical and Computer Engineering; Departments of Surgery, Biomedical Engineering, Pediatrics, Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
¹⁰ Saitama Prefectural Rehabilitation Center, Ageo, Saitama, Japan.
¹¹ Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
¹² Institut Elena Salva. Spinal Deformities Rehabilitation Center, Barcelona, Spain.
¹³ Pediatric Orthopaedic Surgery; Children's Hospital of Wisconsin, Milwaukee WI, USA.
¹⁴ Department of Orthopaedic Surgery; Medical College of Wisconsin, Milwaukee WI, USA.
¹⁵ Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
¹⁶ ISICO (Italian Scientific Spine Institute), Milan, Italy.

PMID: 35320151
DOI: 10.1097/PXR.0000000000000117

Abstract

This review presents the state of the art according to the current evidence on nonoperative treatment for adolescent idiopathic scoliosis, focusing on bracing. The definition of braces for the treatment of adolescent idiopathic scoliosis and a short history are provided. The analysis includes biomechanics, types, existing classifications, indications for treatment, time of brace wear and weaning, adherence, three-dimensional modeling, use of ultrasound imaging for bracing, management of treatment, issue of immediate in-brace correction, and documentation of the outcomes usually assessed for brace treatment, including the quality-of-life issues. According to the current evidence, there are two randomized control trials in favor of bracing. There are insufficient data on the superiority of one brace over another, although it is possible to classify and grade braces for efficacy from nonrigid to rigid and very rigid. Nevertheless, there is consensus on patients' management on the need for teamwork focusing on adherence to treatment, acceptability, and family and patient involvement.

Publication types

Review

MeSH terms

Adolescent
Braces
Humans
Kyphosis*
Quality of Life
Scoliosis* / diagnostic imaging
Scoliosis* / therapy
Treatment Outcome